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Cathy - We are not live with the e-Mar, but I have listed my ideas on the
first 2 things below. See below.
Charlie
Charles R. Downs Pharm.D.
Washington County Hospital
251 E. Antietam Street
Hagerstown, MD, 21740
301-790-8904
[EMAIL PROTECTED]


> FIRST, I had put on the list before that we had an issue with the Next
> Schedule column on the MAR not updating to the next true dose, but
> rather always keeping the earliest missed dose on the screen.  In our
> version, they have made the change to reflect the updated schedule on
> the MAR, and leave the box highlighted in red if there are missed doses
> that have not been documented.  In the future release, I am being told
> that development is addressing the change, but that they will no longer
> be leaving the box red.  Instead, the user will get a pop-up window
> reminder that there is a missed dose on the MAR.  I am having two
> problems with the proposed solution by development:
>    1.  One more window the user will click past and do nothing about.
>    2.  The window will pop-up to any user in the account in PCS - so
> staff not responsible to document that dose will continually be clicking
> it when they go into the account (3 or 4 times a shift).
>
> My nursing staff likes the box staying in red and I have asked Meditech
> to reevaluate this with development.  What do you think?

Why doesn't Meditech make this a customer defined parameter? That way, those
who like the box staying red can have it their way and those prefering a
pop-up window can have it their's.

> SECOND, the issue with the MAR not DCing a med until the last dose is
> documented is also being addressed in 5.5sr4.  I am being told that this
> will be fixed and that the med will DC at the proper stop time,
> regardless of undocumented doses.  FINALLY!  That makes sense.

What if they want to give the dose late? Is this a hard stop date or a soft
stop date? Our orders are discontinued 1 minute after the last date is due.
However, according to our policy, a dose is not late until 1 hour after it
was due. There needs to be a parameter set by the user when this drops off -
an hour later, 2 hours later, whatever. Also, shouldn't there be some kind
of notification that there is still a dose that was not given. What if the
patient was having a procedure and the dose was over an hour. This needs to
be set by policy.


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